Pharmacy Practice-Granada最新文献

Objective: There are concerns with the optimal management of pain in children, with sub-optimal management negatively impacting on physical, emotional social functioning, exacerbated by pain in children being multi-modal. Community pharmacists across countries play an important role in managing pain in patients including children's pain. Consequently, the objective of this study is to assess knowledge, attitudes and practices (KAP) of pain management in children among community pharmacists in UAE.

Methods: A cross-sectional study was conducted using a structured questionnaire that was developed and piloted. The final questionnaire, which comprised two parts, had acceptable validity and internal consistency.

Results: 867 out of 922 community pharmacists took part in UAE (94% response rate) and were visited by trained researchers. The most from independent pharmacies (53.9%) and having more than 10 years of experience (68.9%). The overall KAP score was 70%, with gender, pharmacy type, years of experience, educational level and position significantly associated with KAP. Encouraging knowledge areas included pain is one of the vital signs in children (88.6%), the intensity of pain should be rated by a pharmacist before discussing treatment options (92.2%) and the choice of treatment should depend on issues including intensity and duration (87.2%). Areas of concern included the contents of the WHO analgesic ladder (32.0%) and children may sleep in spite of severe pain (42.9%).

Conclusion: There were areas of good knowledge of pain management among community pharmacists in UAE. Areas of concern including knowledge of the WHO analgesic ladder need to be addressed as part of future educational input during training and post qualification.

Background: The pharmaceutical profession has experienced renewals over time. In community pharmacies, pharmaceutical services contribute to the public health system in Brazil. The development of these tasks, in collaboration with professionals from the multidisciplinary team, demonstrates the involvement with the well-being, health and improvement of the patient's life.

Objectives: This study aimed to identify the professional practice of pharmacists, their understandings and attitudes towards clinical practice in community pharmacies in northern Brazil.

Methods: This is a cross-sectional descriptive study, based on a questionnaire carried out with pharmacists for seven months in the municipality of Belém, in the state of Pará. Data were expressed using descriptive statistics and the results were shown as a percentage.

Results: 182 pharmacists participated. Females were predominant (80.2%) and the average age of participants was 34.2 years. 77.4% graduated from private institutions and 59.3% already have a specialization. 38.4% hold the position of technical director. 50.5% of respondents say that community pharmacies have a reserved place for service. The most used clinical services were pharmacotherapy review (89.5%), health education (60.9%), dispensing (34%), therapeutic monitoring (25.8%) and pharmacotherapeutic follow-up (4.9%). In the study, it was realized that community pharmacies should not be seen as a commercial place but rather as a health care facility.

Conclusions: Therefore, these establishments must adapt at a structural and professional level, to meet an increasingly growing demand of a population in need of services offered with quality health care.

The vaccine was the only way to fight against Coronavirus-19 (COVID-19) from its statement as a pandemic till day. COVID-19 vaccines were approved by the world health organization (WHO) in December 2020. Despite a large number of studies regarding the efficacy and safety of COVID-19 vaccines, to our knowledge, there were limited studies that outlined the gender disparity towards COVID-19 vaccine adverse effects. This study aims to outline the variety of side effects among men and women after getting COVID-19 vaccines (either single or two doses). It is a cross-sectional study accomplished electronically from September to November 2021. The participants involved were 843 Health Care Workers (HCWs) from different cities in Iraq. The majority of respondents were females (664). Around 65% of males experienced adverse effects compared to 77% of females. A high frequency of severe pain was reported among females. Regarding dermatological reactions like swelling, redness and skin rash were also higher reported among female subjects. In addition to that, higher frequencies of moderate and severe systemic adverse effects and mild to moderate nausea was also reported more frequently among females. In terms of cardiopulmonary adverse effects, all the reported adverse effects were found more frequently among females. In conclusion, COVID-19 vaccines produced limited adverse effects and the majority of them were reported among women. This may be associated with hormonal and psychological factors related to them.

Background: Therapy management in patients suffering from mental health disorders is complex and the risks derived from changes or interruptions of treatment should not be ignored. Medication reconciliation in psychiatry may reduce medication errors and promote patient safety during transitions of care.

Objective: To identify the influence of complementary information sources in the construction of the best possible medication history, and to ascertain the potential clinical impact of discrepancies identified in a medication reconciliation service.

Methods: An observational study was conducted in an acute mental hospital unit, with a further validation in an internal medicine unit. Adult patients taking at least one medicine admitted in the unit were included. Patients/caregivers were interviewed upon admission and the information gathered was compared with hospital medical and shared electronic medical records. Once the best possible medication history was gathered, therapeutic information was reconciled against the prescription on admission to identify discrepancies. Potential clinical impact of medication errors was classified using the International Safety Classification.

Results: During the study period, 148 patients were admitted, 50.7% females, mean age 54.6 years (SD=16.3). Collaboration of a caregiver was a needed in 74% of the interviews. In total, 1,147 drugs were considered to obtain patients' best possible medication history. After reconciliation, 560 clinically sound intentional discrepancies were identified and 359 discrepancies required further clarification from prescribers: 84.12% "drug omission", 5.57% "drug substitution", 6.96% "dose change", and 3.34% "dosage frequency change". Potential clinical impact of these medication discrepancies was classified as: 95 mild, 100 moderate, and 29 severe medication errors.

Conclusion: About 1 in three intentional discrepancies observed in a pharmacists-led medication reconciliation service required further clarification from prescribers, being 80% of them unintentional discrepancies. Results highlight the importance of the caregiver as source of information for the psychiatric patient, the relevance of analyzing shared electronic health records until 6 months before, and the need to use hospital medical records efficiently. Additionally, 29 discrepancies were classified as errors with potentially severe clinical impact. A medication reconciliation service is concluded to be feasible and necessary in a mental health unit.

Background: Mental disease burden is increasing globally, and a substantial shortage of mental health professionals remains. Community pharmacists can improve population mental health outcomes to bridge the mental health care gap. However, there is a paucity of data on community pharmacists' provision of mental health care.

Objective: To assess community pharmacist-delivered care to people with mental illness in the United Arab Emirates (UAE), focusing on dispensing and counseling practices, pharmacists' confidence and comfort in providing care, and attitudes and beliefs towards mental illness.

Methods: This was a mixed-methods study with an exploratory, sequential design. Semi-structured interviews explored community pharmacists' practices, challenges and strategies to improve care. Data were analyzed thematically, and the results guided questionnaire development. The questionnaire was also informed by the Framework of Core Mental Health Competencies for All Pharmacy Professionals and other relevant literature and administered to community pharmacists in four out of seven emirates. Logistic regression was used to identify the predictors of pharmacist practices.

Results: In the interviews, community pharmacists described adopting a precautionary attitude and perceived their role as a dispensing one. They reported challenges such as emotional discomfort and lack of training but highlighted the need for a different approach to patients with mental illness. In total, 252 pharmacists completed the questionnaire, and 74% reported performing at least five counseling practices. Logistic regression showed that pharmacists who performed a higher number of practices (≥5) were younger, received continuing education on mental health care in the last two years, and had higher confidence levels.

Conclusion: UAE community pharmacists performed basic dispensing practices and reported discomfort during encounters with patients with mental illness. Training on patient-centered communication skills and psychiatric therapeutics is needed to improve pharmacist-delivered services, alongside increased collaboration with other providers and services.

Objectives: The study aimed to investigate the impact of Coronavirus disease (COVID-19) on the roles of hospital and community pharmacists in the United Arab Emirates (UAE) and to assess how COVID-19 has affected their roles concerning medication dispensing and review, patient education, and telepharmacy services.

Methods: This was a face-to-face questionnaire-based study. A convenient sampling technique was used to collect responses from 428 licensed community and hospital pharmacists across the UAE. The study tool is a structured questionnaire. Data were cleaned and analysed through SPSS Version 26.

Results: In terms of medication dispensing practice, 314 (73.4%) and 210 (49.1%) of pharmacists reported an increase in the dispensing of over the counter (OTC) medicines and antibiotics after COVID-19, respectively. Of the pharmacists included in the study, 380 (88.8%) and 328 (76.6%) reported an elevation in the engagement in patient education and medication review after COVID-19, respectively. On the other hand, 247 (57.7%) and 179 (41.8%) of pharmacists reported that the frequency of their pharmaceutical interventions and physicians' acceptance of those interventions increased after COVID-19, which was significantly associated (p=0.01) with pharmacists' ability to intervene on the dosage regimen of COVID-19 patient.

Conclusion: Pharmaceutical care in the UAE has evolved after COVID-19, particularly in the aspects of medications dispensing, telepharmacy, and patient-centered services..

Background objective: To determine the reasons behind guideline-directed medical therapy (GDMT) non-prescribing, drug utilization before and after excluding those intolerable to GDMT, as well as dose optimization in heart failure (HF) patients with reduced ejection fraction (<40%) (HFrEF) in Oman.

Methods: The study included HF patients seen at the medical outpatient clinics at Sultan Qaboos University Hospital, Muscat, Oman, between January 2016 and December 2019 and followed up until the end of June 2021. The use of renin-angiotensin-system (RAS) blockers (angiotensin-converting-enzyme inhibitors (ACEIs) or angiotensin II receptor blockers (ARBs) or angiotensin receptor-neprilysin inhibitors (ARNIs)), beta blockers and mineralocorticoid receptor antagonists (MRAs) were evaluated as per the European, American, and Canadian HF guidelines. Analyses were performed using univariate statistics.

Results: A total of 171 HFrEF patients were enrolled for this study, the overall mean age of the cohort was 63 ± 15 years old and 59% were male. Over 65% of the patients had chronic kidney disease. Almost 55% of the patients were intolerable to GDMT. The proportion of patients on beta blockers, RAS blockers/ hydralazine-isosorbide dinitrate combination, and MRAs, before and after excluding those intolerable to GDMT, were 89%, 97%, and 77%, and, 94%, 47% and 85%, respectively, while the proportion of patients on the GDMT combination concomitantly was 41% and 83%, respectively. A total of 61%, 44% and 100% of the patients were prescribed ≥50% of the target dose for beta blockers, RAS blockers/ HYD-ISDN combination and MRAs respectively, while 19%, 8.2% and 94% of the patients attained 100% of the target dose for beta blockers, RAS blockers/ HYD-ISDN combination and MRAs respectively.

Conclusions: Reasons behind GDMT non-prescribing were frequent and not clearly obvious in patients' medical notes. The majority of the patients were prescribed GDMT. However, dose optimization, specifically for beta blockers and RAS blockers/ HYD-ISDN combination, was still suboptimal. The findings should be interpreted in the context of low study power and that future studies, with larger sample sizes, are warranted to minimize this limitation.

Objective: The study aimed to explore changes in community pharmacies' processes in response to the pandemic in the United Arab Emirates (UAE) and factors affecting the adoption of these changes.

Method: A cross-sectional study was conducted using a self-administered questionnaire that was distributed to licensed community pharmacists in the UAE. The survey used to collect information on the type of telepharmacy services and related topics such as constraints and supports. The evaluation of services was done for three periods: before, during and after lockdown.

Results: The number of completed surveys was 391. The majority of the participants were under 35 years old (79.5%), female (65.0%), with a bachelor's degree (82.6%), and working in a pharmacy group (70.6%). Pharmacies provided the services by phone (95.6%) and/or messaging applications (80.0%) such as WhatsApp and Messenger. The community pharmacies provided a variety of services using telepharmacy tools such as managing of mild diseases, dispensing and delivering prescribed and OTC medications, general health information, and services for patients with chronic disease. The main factors that had significant effects on several telepharmacy services were pharmacies' type (group/chain vs. individual) and the number of pharmacists in the pharmacy (p < 0.05). Lack of time, training and financial support were the main barriers associated with telepharmacy services among individual pharmacies.

Conclusion: Telepharmacy supported the work of community pharmacies during the COVID-19 pandemic by facilitating the provision of pharmaceutical services. Although the occurrence of several financial and technical problems, it appeared less frequently in pharmacy chains with a large number of pharmacists.

Background: Diabetes is a demanding disease with a complex treatment regimen. Many persons with diabetes have difficulty managing their disease and taking medication as prescribed, possibly because they lack knowledge and sometimes misinterpret medical benefits. Community pharmacies continuously provide professional counselling to persons with diabetes.

Objective: This study aimed to explore 1) which services adults with type 1 and type 2 diabetes want from community pharmacies and 2) how pharmacies can meet these wishes.

Methods: A qualitative, explorative study design using focus group interviews was chosen. Informants were recruited from Region Zealand in Denmark. Data were digitally recorded, transcribed verbatim and analyzed by means of thematic analysis.

Results: Thirteen adults (11 female) with the mean age of 66.2 years (range 49-81 years) participated in one physical (n=6) or one online (n=7) focus group interview. Ten had type 2 diabetes, three had type 1 diabetes. The average duration of participants' diabetes was 13.4 years (range 2.3-33.0 years). The analysis revealed three overall themes of the functions which the informants would like community pharmacies to fulfil: 1) raise awareness of pharmacies' counselling service and competences; 2) act as a dialogue partner; 3) be a source of information and guidance about local activities and support.

Conclusion: The informants did not regard community pharmacies as a natural part of the healthcare system or as a place where they would expect counselling. They would like the community pharmacy to make their medical competences and services obvious and the community pharmacy staff to act as a dialogue partner and provide competent counselling. The informants would like to have a contact person with diabetes competences with whom they can book an appointment to complement over-the-counter counselling. They experience a gap in their care between routine visits in the healthcare system and suggest that community pharmacies counselling services become a natural supplement and that healthcare professionals in the primary and secondary sectors inform patients about the services - especially for patients newly diagnosed with diabetes. Finally, they would like a formal collaboration between diabetes associations and community pharmacies to make their competences, services and information visible.